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Belinda
Research Team
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Posted: Mon May 9th, 2005 17:34 |
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Do sunscreens prevent the production of Vitamin D?
"Not only is the sun block insufficient, the concept that it will allow you to freely move out-of-doors is flawed. You cannot change the way your body works as it heals. Nobody, not one person, has managed to recover without drastically changing their lifestyles. I am sorry, that is just the way it is." ..Trevor..
Most conventional sunscreens, no matter what they claim, do not prevent the synthesis of Vitamin D in the skin. Here are some published references that provide support for our answers.
Scarlett, W.L.
Ultraviolet radiation: sun exposure, tanning beds, and vitamin D levels. What you need to know and how to decrease the risk of skin cancer.
J Am Osteopath Assoc. 2003 Aug;103(8):371-5. Review.
“Several large prospective studies have shown that vitamin D deficiency does not result from regular sunscreen use.”
Moloney FJ, Collins S, Murphy GM.
Sunscreens: safety, efficacy and appropriate use.
Am J Clin Dermatol. 2002;3(3):185-91. Review.
“Vitamin D levels are not significantly affected by regular use of a sunscreen.”
This is the Spanish study:
Farrerons J, Barnadas M, Rodriguez J, Renau A, Yoldi B, Lopez-Navidad A, Moragas J.
Clinically prescribed sunscreen (sun protection factor 15)does not decrease serum vitamin D concentration sufficiently either to induce changes in parathyroid function or in metabolic markers.
Br J Dermatol. 1998 Sep;139(3):422-7.
This is the Australian Study – a randomized controlled trial:
Marks R, Foley PA, Jolley D, Knight KR, Harrison J, Thompson SC.
The effect of regular sunscreen use on vitamin D levels in an Australian population. Results of a randomized controlled trial.
Arch Dermatol. 1995 Apr;131(4):415-21.
“All participants had at least one solar keratosis... No person, including those aged 70 years and over, developed any vitamin D levels outside the normal reference range during the period of the study."
This study is from the Dermatology Clinical Research Unit, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD.
Sollitto RB, Kraemer KH, DiGiovanna JJ.
Normal vitamin D levels can be maintained despite rigorous photoprotection: six years' experience with xeroderma pigmentosum.
J Am Acad Dermatol. 1997 Dec;37(6):942-7.
Products that are somewhat effective in reducing Vitamin D and/or 1,25-D production
Ketoconazole 2% cream does prevent the production of 1,25-D in the skin. For more information, please see How does ketoconazole cream work?
Zinc oxide, used in some sunscreens (not used in the studies above) appears to help prevent 25D and 1,25D production in the skin. See below for "Sunscreen Overview" -- Updated Feb. 24, 2008.
Last edited on Mon Feb 25th, 2008 03:13 by
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jcwat101
Research Professional
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Posted: Mon Feb 25th, 2008 03:06 |
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[filelink]
Sunscreen Overview
By Joyce Waterhouse
Abstract
The majority of sunscreens are ineffective in blocking vitamin D production or blocking sun flare symptoms in Th1 patients. However, zinc oxide containing sunscreens (3-10% zinc oxide) appear to work as well as Ketoconazole cream for blocking sun sensitivity symptoms in those with slight to moderate sun sensitivity, at least for brief exposures. For more severe levels of sun sensitivity, it appears to work better to use sunscreens with a higher percentage of zinc oxide (16-25%) or both ketoconazole and high percentage zinc oxide. Zinc oxide may inhibit both 25D and 1,25D production, whereas Ketoconazole cream only affects 1,25D. Ketoconazole cream may inhibit bacterial killing, especially in the skin areas where it has the highest concentration.
Neutrogena’s Helioplex, containing "stabilized" avobenzone (regular avobenzone does not work), and sunscreens containing titanium dioxide may also help block vitamin D production and reduce or prevent sun flare symptoms under some circumstances. All the products appear to be fairly safe, are used widely and are FDA approved, however some studies have raised safety question, which are discussed below. Further conclusions, data and a discussion of various sunscreen products are provided below, including information on how long the sunscreens’ protective effects appear to last, the effect of washing and the use of Ketoconazole (Nizoral) shampoo in protecting the scalp and as a body wash.
Note (Feb. 24, 2008): Recently, some new observations have been made indicating that the nature and timing of sun reactions may differ at different stages of the MP for some people and additional caution may be warranted (see Addendum, below, for additional information). Also, there is some evidence indicating that for some people, when at a later stage, it may be much more helpful to use a high percentage zinc oxide sunscreen (e.g., 20%) than the other ones discussed, even if other sunscreens worked equally well earlier in the MP. But it is clear that even the higher level of zinc oxide allows some vitamin D production, which can become quite large if a long time is spent outdoors and/or more skin is exposed.
Report on Results of Zinc Oxide Sunscreen Study
Zinc Oxide Sunscreen and Other Broad Spectrum Sunscreens That May Reduce Vitamin D Production
The Marshall Protocol research staff decided to gather data to determine the degree to which the micronized or nanoparticle forms of zinc oxide used in various sunscreens might protect Th1 patients from photosensitivity symptoms and increased vitamin D levels. These relatively translucent forms of zinc oxide have been developed to avoid the white coating of the skin that occurs when the traditional opaque form of zinc oxide sunscreen is used.
Although Ketoconazole cream reduces or eliminates sun flare symptoms for many people (see How Does Ketoconazole Work?), the need for a prescription, the expense, and the fact that it does not work for everyone indicated it would be useful to investigate zinc oxide as an option to reduce symptom exacerbations due to sun exposure. Also, Dr. Marshall thinks that use of Ketoconazole in the cream and shampoo should probably be minimized since it may negatively affect the ability to eliminate bacteria, especially in the skin, where the concentrations of ketoconazole would be highest. The reason for this is the ability of Ketoconazole to block the VDR (Ki=2) as shown by molecular modeling calculations.
Ketoconazole cream blocks the conversion of 25D to 1,25D, which is helpful for reducing sun flare symptoms and other potentially negative effects from excess 1,25D (like suppression of adaptive immunity and bone loss). But now that we are especially concerned about elevated 25D blocking bacterial killing through blocking VDR activation, there is reason to investigate ways to block 25D formation in the skin -- something zinc oxide may be able to do over a broad spectrum of wavelengths.
Usually we say that the skin of Th1 patients mainly produces 1,25D because almost all the 25D produced in the skin is converted straight to 1,25D due to high inflammatory cytokines, such as TNF alpha. But this may not always be true -- either because some people don't have as high a level of inflammatory cytokines or because they are wearing Ketoconazole cream that blocks the conversion from 25D to 1,25D (leaving the 25D produced when exposed to the sun to go into the bloodstream).
Some people may choose to wear a sunscreen in any case for any protection from skin aging and/or skin cancer that they may offer. So this is another reason it seems useful to find out whether certain sunscreen ingredients might offer the added benefit of protecting from sun flare symptoms through reducing vitamin D production in the skin.
Some people have reported two other broad spectrum sunscreen ingredients, titanium dioxide and "stabilized" avobenzone (found only in Neutrogena’s Helioplex products), have worked for them and they will be discussed below within the other sections. No other sunscreen ingredients we have investigated so far, including most of the common chemical sunscreens used to block UVB radiation, appear to offer any significant level of protection from vitamin D production and sun flare symptoms in Th1 patients.
Always keep in mind the information in this FAQ:
What are the latest recommendations regarding sun exposure?
Summary of Major Points Derived From the Study
Note: When considering sun protection options, it should be remembered that the best protection from sun exposure besides staying indoors in the daytime, is provided by wearing dark, tightly woven clothing and NoIR sunglasses.
--Zinc oxide seems to work as well as Ketoconazole cream for the moderately or slightly sun sensitive in prevention of sun exposure symptoms related to vitamin D.
--For some of the most severely sun sensitive, Ketoconazole cream or shampoo seems to work better for preventing or reducing sun flare symptoms, but for others, zinc oxide seems to work better.
--Using both Ketoconazole cream and zinc oxide sunscreen together may more completely block exacerbations from sun exposure for some people. It does not matter which is applied first, but you may want to let one sink in for a minute or two before applying the other.
-- Helioplex (must be "stabilized" avobenzone -- found in two Neutrogena products) may possibly work as well as zinc oxide for some people. The Helioplex does not appear to last as long (see below). (Note: The FDA prohibits combining avobenzone with zinc oxide or titanium dioxide, so both types of sunscreens should not be applied at the same time).
--A higher percentage of zinc oxide works better than a lower percentage and this may be particular important in people who are more sun sensitive or who are especially concerned about lowering their 25D and 1,25D levels.
--Ointments containing zinc oxide that are used to treat rashes and other skin conditions usually do not contain the micronized or nanoparticle form and will appear like white face paint. It will probably work, but most people do not care for the appearance.
--Zinc oxide, titanium dioxide and Helioplex are more likely to keep 25D levels down than Ketoconazole cream.
--Ketoconazole cream keeps 1,25D down by preventing conversion of 25D to 1,25D and if it has any effect on serum 25D, it would probably tend to increase its blood levels if the patient is exposed to the sun. By reducing its conversion to 1,25D, it would tend to leave more 25D to enter the bloodstream.
--Ketoconazole cream and shampoo seem to last 48 hours for some people, but a much shorter time for others. Once Ketoconazole has been allowed to soak in for a few minutes, it is still effective after washing.
--Zinc oxide and titanium dioxide may be washed off (also rubbing or perspiration might remove them to varying degrees depending on the water resistance of the sunscreen). A thicker coating of titanium dioxide may be needed than of zinc oxide. For many people the zinc oxide sunscreens seem to last all day (and maybe for several days if they are not washed or rubbed or perspired off).
--Neutrogena’s products containing Helioplex (stabilized avobenzone) seem to last 90 minutes to 3 hours depending on how heavily the sunscreen is applied. However, Helioplex does not seem to wash off once it has been allowed to soak in completely.
--For most sun sensitive Th1 patients, it is still important to wear a hat that will block the light whenever they are outside or in a car or other place where sun comes in through the windows; and most still need to wear NoIR sunglasses. However, some have found that using Nizoral (Ketoconazole) shampoo allows them to go outside without a hat at least briefly and avoid a symptom exacerbation from the sun (though 25D production probably will occur). Also, as it is being rinsed out of the hair, if it comes in contact with other areas of the body, the ketoconazole is absorbed by the skin and seems to provide some protection from sun flare symptoms for some patients.
--NoIR sunglasses and sunscreen: One should make sure one does not allow zinc oxide to come into contact with the NoIR lenses, as one person reported it damaged them. Make sure your fingers are clean of zinc oxide or it is soaked in or dried well before putting on or handling your glasses. Care should probably also be taken with other lotions as well with regard to contact with the NoIR lenses.
--Dry Skin: Some people find the zinc oxide sunscreens to be drying to the skin. Most people who have this problem apply another moisturizing lotion in addition to the sunscreen.
--Self-Mixed Sunscreens. A few patients have found it difficult to find a commercial sunscreen that they tolerate (due to chemical sensitivities) and have added micronized zinc oxide to their favorite lotion to make their own sunscreen (see: http://marshallprotocol.com/forum11/8840.html and this recipe: http://www.geocities.com/knochen_mp/Sunscreen.html).
Safety
All of the products are FDA approved, but some research has raised safety issues that Th1 patients may want to consider in their decision of what, if any product, they want to use.
Safety of Inorganic Sunscreens (Micronized or Nanoparticle Zinc Oxide and Titanium Dioxide)
Note: If the sunscreen contains organic chemical sunscreen ingredients in addition to the zinc oxide or titanium dioxide, see Safety of Synthetic Organic Chemical Sunscreens below.)
All the sunscreens are FDA approved and widely used, but some research has raised safety issues that Th1 patients may want to consider in their decision of what product to use.
A recent review from the Australian government indicates that zinc oxide and titanium dioxide in the nanoparticle form are likely to be safe (see review at http://www.tga.gov.au/npmeds/sunscreen-zotd.htm ). For all the details of the analysis, look at the PDF at the above link, which contains the review of the literature accepted by the Medical Evaluation Committee of the Australian government (Feb. 2006).
Quoting from this Australian government report:
"There is evidence from isolated cell experiments that zinc oxide and titanium dioxide can induce free radical formation in the presence of light and that this may damage these cells (photo-mutagenicity with zinc oxide). However, this would only be of concern in people using sunscreens if the zinc oxide and titanium dioxide penetrated into viable skin cells. The weight of current evidence is that they remain on the surface of the skin and in the outer dead layer (stratum corneum) of the skin."
In other words, the evidence indicates that the nanoparticle form of titanium dioxide and zinc oxide are unable to penetrate to the layer of living skin cells (e.g., see the biopsy studies). Also, a study showed no evidence of increased systemic levels of zinc in human volunteers who applied the nanoparticulate zinc oxide sunscreen to their skin.
As far as wildlife and the environment in general, since the zinc oxide and titanium dioxide nanoparticles are washed off and enter the water ways, there may be valid reasons to want more studies and for environmental groups to be concerned. But, for an individual with a Th1 disease, many may feel that abstaining from using zinc oxide sunscreen will not make enough of a difference to the wildlife for us to be too concerned, when their use is so widespread.
As far as human safety, some people may decide that the FDA and other government's approval of these products, the studies reviewed in the article link above and the lack of reports of anyone with liver or kidney problems reporting damage despite the widespread use of the sunscreen for a number of years are not enough reassurance for them and they are welcome to continue the other sun avoidance measures instead.
Note: Apparently nanoparticles are considerably smaller than the micronized particles. Although no harm from nanoparticles has been proven and they do not appear to be significantly absorbed into the deeper layers of the skin, some feel the micronized zinc oxide is safer than the nanoparticle zinc oxide.
Also, see the cautions in What are the new recommendations regarding sun exposure?
If the sunscreen contains synthetic organic chemical sunscreen ingredients in addition to the zinc oxide or titanium dioxide, you may wish to consult Safety – Synthetic Organic Chemical Sunscreens
Safety of Synthetic Organic Chemical Sunscreens
A number of synthetic chemical sunscreen ingredients are used together with the zinc oxide, especially in those sunscreens with lower zinc oxide levels, in order to boost the SPF rating (based on UVB light). Some people with multiple chemical sensitivities (MCS) have problems with many chemical ingredients and fragrances in sunscreens and other products. Those who are concerned about chemical exposures can look at the various sunscreens and look for a more "natural" one that only uses the zinc oxide without any synthetic chemical sunscreens. Some products (e.g., the Kabana sunscreen or UV Natural, for instance) even forego the inactive synthetic chemicals found in various lotions and sunscreens, in favor of all natural ingredients.
Web sites that sell zinc oxide sunscreens without other synthetic organic chemical sunscreen ingredients often criticize the other "chemical" sunscreens. They say that the chemicals are absorbed by the body and may have negative effects that have not been adequately studied and may put additional demands on the liver and kidneys. It is true that the chemicals are absorbed by the body and must be excreted by the body. But just like with Ketoconazole cream, there are no warnings for people with liver and kidney disease, nor have I found any reports of people having problems with their livers or kidneys from sunscreen use. But there is a theoretical possibility of a problem and people may decide it is best to avoid them or to minimize exposure, especially if they have had problems with chemicals in the past.
There is also some suggestion that certain sunscreen ingredients might be endocrine disrupters and this article, C&EN: COVER STORY - SPOTLIGHT ON SUNSCREENS (http://pubs.acs.org/cen/coverstory/7949/7949sunscreens.html) , discusses the issue. People will have to judge for themselves regarding this incomplete information. The two chemicals that seem to be the most problematic according to the article, 4-methylbenzylidene camphor (4-MBC) and octyl methoxycinnamate (OMC), are found in only a few of the sunscreens with zinc oxide.
It is probably safest, if you want to minimize any unnecessary chemical exposure, to choose a sunscreen with fewer chemicals, especially since the chemical sunscreen components are not contributing to the reduction in sun flare symptoms. One exception to this is the stabilized avobenzone in the form of Helioplex, found in two Neutrogena sunscreens, which some people have found to block sun flare symptoms associated with Th1 disease. Para aminobenzoic acid (PABA) should be avoided, but since it is almost never included as an ingredient in sunscreens any more, this is not difficult.
Review of Products Members Have Reported On
(Note: the Autoimmunity Research Foundation does not endorse or have any affiliation with any commercial enterprises involved with producing or selling these products)
The following products are the ones that seem to have been used the most by people on the Marshall Protocol. Most products may be purchased over the Internet. Although the products are relatively translucent, some of them, especially with higher percentages of zinc, may show up to some degree on the skin. Those with highest percentages of zinc generally tend to lack the additional chemical sunscreens. These chemical sunscreens are included in many of the other products but have not been found to be helpful in reducing sun related symptoms in Th1 patients in our experience so far. Herbal extracts probably should be avoided when possible, as they may have unknown effects on the immune system.
Note: The first 3 listed below have the highest concentrations of zinc oxide
Megan Gale's new Invisible Zinc Sunscreen, 16 % zinc oxide, http://www.adorebeauty.com.au/adorebeauty/viewItem.asp?idproduct=2491 . Active Ingredient: Zinc Oxide 154 mg/g. Other Ingredients: Water, Zinc Oxide, Propylene glycol, polyethylene, sodium chloride, Caprylic/capric triglyceride, Diazolidinylurea, Glyceryl Laurate, Iodopropynyl butylcarbanate, Isostearyl neopentanoate, PEG-30 Dipolyhydroxystearate.
Several people find this product satisfactory though some felt it made their skin somewhat whiter; one had to discontinue its use because her eyes became too itchy (even when not used very close to her eyes).
Kabana http://www.kabanaskincare.com/ingredientsdetails.htm 20% zinc oxide, has all natural ingredients: lanolin, shea butter, cocoa butter, mango butter, jojoba oil, soy lecithin, natural vitamin E and Eldorado Springs water . Some think it seems a little greasy, especially when first applied.
(Note: I understand that Kabana is developing some newer products including one that can be applied more smoothly and easily and is also experimenting with a tinted product. I have also talked to the owner and he says that for some time now, they have been using a zinc oxide that is micronized rather than the nanoparticle type. The nanoparticles are generally much smaller than the micronized particles and some feel that the larger micronized particles are safer -see below - Joyce Waterhouse).
UV Natural, 23% zinc oxide, the most of any sunscreen on the market. Available on the Internet and from Whole Foods. However, one person reported: "I would say it feels and looks quite greasy, despite the claims, and has a pinkish tone - probably to hide the white zinc oxide color - which you have to blend into your skin."
http://www.goldenglow.com.au/ggecomm/productView.jsp?ProductId=13864
Zinc Oxide. Oils of: Safflower, Macadamia nut, Sesame, Grape seed, White beeswax, Vegetable oil, Hydrogenated vegetable oil, Candellila wax, d-alpha-tocopheryl acetate (vitamin E), Carnauba wax, Extracts of Camellia sinensis (green tea) leaf, Vitis vinifera (grapeseed) seed. Iron oxide yellow C33-7720, Iron oxide red C33-7721, Ascorbyl palmitate.
Glycolix Elite Sunscreen SPF 30
Ingredients: Active Ingredients: Zinc Oxide 17% Also contains: Purified Water, C12-15 Alkyl Benzoate, Cyclomethicone, Laurylmethicone Copolyol, C13-14 Isoparaffin, Polyacrylamide, Ceresin, Dimethicone, Green Tea Extract, Phospholipids, Ascorbyl Palmitate, Tocopheryl Acetate, Retinyl Palmitate, Coenzyme Q-10, Ascorbyl Glucosamine, Superoxide Dismutase, Laureth-7, Sodium Chloride, Methylparaben, Propylparaben, Diazolidinyl Urea. This one does apply more smoothly. It has a slight odor but does not seem as bad as many products. I found the odor more tolerable than the Coppertone. This one is available from http://Amazon.com
Coppertone Spectra3 -- this product has been discontinued
Oil of Olay Complete All Day UV Defense Moisture Lotion for Sensitive Skin: 3% zinc oxide, http://www.drugstore.com has it, and it has been purchased at K mart and Walmart
Active Ingredients: Octinoxate 6% (6%), Zinc Oxide 3% (3%)
Inactive Ingredients: Water, Isohexadecane, Glycerin, Polyacrylamide, C13-C14 Isoparaffin, Laureth 7, Cyclopentasiloxane, PEG/PEG-20/20 Dimethicone, Steareth 21, Stearyl Alcohol, Sucrose Polycottonseedate, Behenyl Alcohol, Tocopheryl Acetate, Cetyl Alcohol, DMDM Hydantoin, Iodopropynyl Butylcarbamate, Steareth 2, Disodium EDTA, Aloe Barbadensis Leaf Juice, Oleth 3 Phosphate
Trader Joe’s sunscreen, 10% zinc oxide, fragrance free, water resistant, reported to be tolerated on face Octinoxate 7.5% Octisalate 5% Oxybenzone 2.5% Zinc Oxide 10% under $4 for 4 oz.
A patient with MCS found a couple brands that she tolerated well, Solbar Zinc and Elta Block:
Solbar Zinc SPF 38, 7.5% zinc oxide Active ingredients are Homosalate (10.0%), Octinoxate (7.5%), no fragrance listed
Elta Block SPF 32, 4.5% zinc oxide (Z-Cote). Octyl Methoxycinnamate (7.5 %), Octyl Sallicylate (5.0 %), no fragrance listed
She commented that this seems a facial quality moisturizer and it felt lighter and better absorbed than the Solbar
Both are available from Sun Precautions (1-800-882-7860) and Elta Block is also available from Medwing (1-877-MEDWING) and Solbar is also available from The Derm Store (1-800-213-DERM).
BASF makes a transparent (micronized) coated zinc oxide known as Z-COTE. It can be found in several products. Dermatone makes one with 8.5% zinc oxide.
Walgreens brand Sunblock, 6.86% zinc, SPF45, it also has octinoxate & octocrylene as active ingredients. Plus, it lists triethoxycaprylylsilane (The "coating" some products use for microfine particles)
Blue Lizard comes in a few versions, some with 6% zinc oxide, and some with 10% zinc oxide and 5% titanium dioxide. All versions include the "nano particle coating" ingredients, has fragrance
Blue Lizard Australian Sunscreen Baby and one for Sensitive Skin includes: Titanium Dioxide 5% , Zinc Oxide 10%
Several other Blue Lizard sunscreens have: Octinoxate 7.5% , Octocrylene 2% , Oxybenzone 3% , Zinc Oxide Z-Cote - 6%
SolarSense is reported to contain Octinoxate 7.5%, Zinc Oxide 6.65%, and Oxybenzone 4%. One person reported the odor does not bother her and she can use it on her face and she says "it leaves my skin feeling both wonderful and normal."
These might provide some additional options for the face:
Philosophy the supernatural airbrushed canvas, natural spf 15
Active Ingredients: Zinc Oxide (9.8%) (Sunscreen)
Inactive Ingredients: Mica (ci 77019), Silica, Bismuth Oxychloride (ci 77163), Titanium Dioxide (ci 77891), Dimethicone, Iron Oxides (ci 77491, ci 77492, ci 77499), Triethoxycaprylylsilane, Phenoxyethanol, Methylparaben, Ethylparaben, Propylparaben, Butylparaben, Isobutylparaben
Mineral makeups marketed these days (like Larenim and Bare Minerals) include titanium dioxide and zinc oxide.
Two people have discussed making their own sunscreen since they are having trouble finding a product they tolerate.
One person reported on a source of the micronized translucent zinc oxide:
"Somerset Cosmetic Company
http://www.makingcosmetics.com/
Look at the ingredients section under sunscreens. This is the pure zinc oxide in powder form.
50 grams @$7.95 (1.8 ounce) (US)
250 grams (8.8 ounce) @$31.80
This is not cheap, but if you have MCS or just want to have your own lotion formulation from a compounding pharmacy, now you can do it. Somerset also has everything you need if you want to make your own lotion from scratch and really control the ingredients."
Non Zinc Oxide Containing Sunscreens that May Work at Least Partially
Helioplex -- Stabilized Avobenzone: Neutrogena Ultra Sheer, Dry-Touch Sunblock, SPF 55 and Neutrogena Age Shield Sunblock, SPF 30 (below are ingredients from SPF 30 version, the SPF 55 version had slightly higher concentrations of the non avobenzone ingredients, see http://drugstore.com or other sites for more complete information)
Active Ingredients: Avobenzone 3.0%, Homosalate 8.0%, Octisalate 4.0%, Octocrylene 2.35%, Oxybenzone 5%
Inactive Ingredients: Water, Glycerin, Dimethicone, Silica, Diethylhexyl 2,6 Naphthalate, Caprylyl Methicone, Potassium Cetyl Phosphate, PPG-17/IPDI/DMPA Copolymer, Hydrogenated Palm Glycerides, Glyceryl Stearate, PEG 100 Stearate, Tocopheryl Acetate, Bisabolol, BHT, Polymethyl Methacrylate, Pantothenic Acid, Retinyl Palmitate, Ascorbic Acid, Trimethylolpropane Triethylhexanoate, Camellia Ofeifera Extract, Tocopherol, Butylene Glycol, Calcium Pantothenate, 1, 2-Hexanediol, Caprylyl Glycol, Acrylates/C10-30 Alkyl Acrylate Crosspolymer, Hexylene Glycol, Tetrasodium EDTA, Triethanolamine, Methylparaben, Chlorphenesin, Propylparaben, Phenoxyethanol
Titanium dioxide: One person says Hamilton Quadblock works well for him, possibly due to it being especially water/perspiration resistant – it has titanium dioxide and no zinc -- it tends to show up with a white color on your skin, though it is apparently not as white looking as the old-fashioned zinc sunscreens that look like face paint (http://www.hamiltonlabs.com.au/index.cfm )
QUADBLOCK 30+ SUNSCREEN LOTION ( 125mL BOTTLE) WATER RESISTANT 4 hours Active Content: 4 -Methylbenzylidene Camphor 4.0% Octyl Triazone 1.5% Titanium Dioxide 7.4% Preservative ContentTotal hydroxybenzoate esters 0.5% Diazolidinyl Urea 0.2%
Addendum (Feb. 24, 2008)
Joyce Waterhouse
Some people find that the nature of their sun reaction may change over time. It is important to take this into consideration if you are not progressing adequately, if you are having excessive symptoms or if you have a more serious and long-standing medical condition. Here I give an example of how my own reaction has changed over time. There appears to be a wide variety of responses, so your reactions may differ.
I used to have immediate reactions starting in just a few minutes, including fatigue, weakness, an increase in heart rate and a shaky feeling. And I recovered within a few hours. Now, in contrast, my reaction to natural light exposure (even on a very cloudy day) starts about 30 hours after exposure, peaks two to three days later, and lasts almost 7 days after the exposure and the reaction more closely resembles my typical immunopathology symptoms. This delayed effect, of course, can make it much harder to figure out. For me, it took avoidance of natural light/sun for a while and then a brief re exposure (just 5 to 10 minutes) to reveal the role the sun was playing in my symptoms.
I also now find I notice a much more protective effect from a higher percentage zinc oxide, like Kabana's sunscreen (20%) than lower percentages (like many with 3-10% zinc oxide), and much less effect from other types of products discussed here (Helioplex and Ketoconazole). In fact, I do not find the ketoconazole protecting me at all from the type of reaction I have now. This is despite that fact that it used to protect me from the reactions I used to have.
So, if you think you are no longer having sun reactions, but are having a difficult time with symptoms or your progress, it may help to try to reduce your sun exposure and use a higher percentage zinc oxide sunscreen when you do have to go out to see if that helps your situation over time.
I should emphasize, though, that even the highest percentage zinc oxide sunscreen lets some solar radiation through and this can cause vitamin D production and symptoms. This will be especially significant if a larger area of skin is exposed or the exposure is longer. This is true even if in a car, the shade or in cloudy weather. It should be remembered that one can still get sunburned with sunscreen on even if it is a powerful sunscreen, if you are out long enough. The SPF factor really only means that it takes longer to get to that point than without the sunscreen.
So, avoidance of daytime natural light/sun exposure and, when you have to go out, the use of dark, tightly-woven clothing, hat and gloves, are by far the most protective approaches. Even the strongest sunscreen should not be considered as allowing adequate protection for many of the more sensitive people, but is something some people find helpful, particularly for brief exposures for areas like the face and when other options are unavailable.
Sunscreen use should not be seen as a replacement for sun avoidance measures, but only as a tool that sometimes helps when used in conjunction with sun avoidance measures.
Particularly for people with more serious conditions, I urge extra caution with regard to natural light/sun exposure -- for a few of the most sensitive, even 5 minutes or less of natural light may cause a significant reaction.
See April 2, 2008 post at: http://marshallprotocol.com/forum30/5390-2.html for possible improved protection via more than one coat of high % zinc oxide (e.g., one at night and one the next morning).
Aussies: Compoundia make Invisible Zinc cream
____________________
20 yrs with CFS/FM/Lyme/IBS, food sensitivities; 1,25D/25D 8/04:64/11 1/05:22/6 9/05:1,25D=12 10/06:22/8, 4/07:25/<4 chewed Ben. 40mg q8h; Mod. P2: 2/23/05, P2: 4/06; P3: 1/1/07
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